多通道经皮肾镜与单通道经皮肾镜联合输尿管软镜治疗复杂性肾结石的效果比较  

Comparison of multiple-tract percutaneous nephrolithotomy and single-tract standard percutaneous nephrolithotomy combined with flexible ureteroscope lithotripsy in the treatment of complex renal calculi

作　　者：郑健忠[1] 梁福律 范先明[1] 郭昭建[1] 林剑峰[1] 涂建平[1] 叶振扬[1] 方荣金[1] 

机构地区：[1]福建中医药大学附属厦门市第三医院泌尿外科,福建厦门361100

出　　处：《现代泌尿外科杂志》2016年第8期593-596,共4页Journal of Modern Urology

摘　　要：目的探讨多通道经皮肾镜(PCNL)与单通道标准PCNL联合输尿管软镜(FURSL)治疗复杂性肾结石比较。方法回顾性分析2011年1月至2015年12月收治的93例复杂性肾结石的临床资料及治疗方法。其中A组为多通道PCNL组(33例);B组为单标准通道PCNL联合顺行或者逆行FURSL组(60例)。比较两组患者的年龄、结石大小、手术时间、术后血红蛋白下降值、术后住院天数、清石率和并发症等。结果 A组与B组年龄分别为(48.36±13.15)vs.(49.23±13.34)岁,结石直径分别为(3.65±0.47)vs.(3.55±0.39)cm,术后住院天数分别为(7.64±1.67)vs.(8.2±2.46)d、术后总结石清除率(81.8%)vs.(93.3%),并发症分别为(9.09%)vs.(6.67%),其间比较无统计学差异。A组与B组手术时间分别为(106.94±25.08)vs.(130.73±33.84)min,术后血红蛋白下降值分别为(14.33±7.14)vs.(10.90±4.79)g/L,期间比较有统计学差异。结论对于复杂性肾结石,多通道PCNL仍是一种可供选择的一线治疗方案。然而单标准通道PCNL联合FURSL,在减少手术出血上有优势。医生应根据其医疗设备、手术技能和患者的特点,为患者制定最优方案。Objective To compare the clinical efficacy of multiple-tract percutaneous nephrolithotomy （multi-tract PC- NL） and single-tract standard percutaneous nephrolithotomy （single-tract PCNL） combined with flexible ureteroscopic litho- tripsy （FURSL） in the treatment of complex renal calculi. Methods Clinical data of 93 patients who underwent either multi- tract PCNL （n = 33） or single-tract PCNL combined with FURSL （n = 60） during Jan. 2011 and Dec. 2015 were retrospective- ly analyzed. Patients＇ age, stone size, operation time, hemoglobin decline, postoperative hospital stay, stone free rate and complications were compared between the two groups. Flesults The mean age, stone size, postoperative hospital stay, stone free rate and complications of multi-tract PCNL group and single-tract PCNL combined with FURSL were （48.36±13.15）vs. （49.23±13.34） years old, （3.65±0.47） vs.（3.55±0.39）cm, （7. 64±1. 67） vs. （8.2±2.46）days, （81.8%） vs.（93.3%）, and （9.09%） vs. （6.67%）, with no significant differences. The operation time, hemoglobin decline of multi-tract PCNL group and single-tract PCNL combined with FURSL group were （106.94±25.08） vs. （130.73±33.84）min, （14.33±7.14） vs. （10.90±4.79） g/L, with statistical differences （P〈0. 05）. Gonclusions For complex renal calculi, multi-tract PCNL is still a first-line choice. However, single-tract PCNL combined with FURSL is more effective as it has an advantage in minimizing bleeding during surgery. Urologists should make the best choice depending on the armamentarium, the operator＇s skills, and various patients＇ characteristics.

关 键 词：标准经皮肾镜 输尿管软镜 复杂性肾结石 

分 类 号：R692.4[医药卫生—泌尿科学]